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Impact of age on survival in radioiodine refractory differentiated thyroid cancer patients.

年龄对放射性碘难治性分化型甲状腺癌患者生存的影响。

  • 影响因子:5.04
  • DOI:10.1530/EJE-20-1073
  • 作者列表:"Saïe C","Wassermann J","Mathy E","Chereau N","Leenhardt L","Tezenas du Montcel S","Buffet C
  • 发表时间:2021-05-01
Abstract

Objective:The objectives of our study were to analyze the influence of age on the survival of patients with RAIR-DTC and to determine their prognostic factors according to age. Methods:This single-center, retrospective study enrolled 155 patients diagnosed with RAIR-DTC. The primary end point was overall survival (OS) according to different cutoff (45, 55, 65, 75 years). Secondary endpoints were progression free survival (PFS) and prognostic factors in patients under and over 65 years. Results:Median OS after RAIR diagnosis was 8.2 years (95% IC: 5.3-9.6). There was no difference according to age with a 65 (P = 0.47) and 55 years old cutoff (P = 0.28). Median OS improved significantly before 45 years old (P = 0.0043). After 75 years old, median OS significantly decreased (P = 0.0008). Median PFS was 2.1 years (95% CI: 0.8-3) in patients < 65 years old, and 1 year in patients ≥ 65 years old (95% CI: 0.8-1.55) with no statistical difference (P = 0.22). There was no impact of age on PFS with any cutoff. In both groups, progressive disease despite 131I treatment reduced OS. In patients < 65 years old, an interval of less than 3 years between the initial diagnosis and the diagnosis of RAIR metastatic disease was predictive of poor survival. In patients > 65 years old, the presence of a mediastinum metastasis was a significant factor for mortality (HR: 4.55, 95% CI: 2.27-9.09). Conclusion:In RAIR-DTC patients, a cut-off age of 65 years old was not a significant predictive factor of survival. Forty-five and 75-years-old cutoff were predictive for OS but not PFS.

摘要

目的: 本研究的目的是分析年龄对RAIR-DTC患者生存的影响,并根据年龄确定其预后因素。 方法: 这项单中心的回顾性研究纳入了155例诊断为RAIR-DTC的患者。主要终点是根据不同的截止值 (45,55,65,75年) 的总生存期 (OS)。次要终点是65岁以下和65岁以上患者的无进展生存期 (PFS) 和预后因素。 结果: RAIR诊断后的中位OS为8.2年 (95% IC: 5.3-9.6)。根据年龄,65岁 (P = 0.47) 和55岁的截止值 (P = 0.28) 没有差异。中位OS在45岁之前显著改善 (P = 0.0043)。75岁以后,中位OS显著下降 (P = 0.0008)。<65岁患者的中位PFS为2.1年 (95% CI: 0.8-3),≥ 65岁患者的中位PFS为1年 (95% CI: 0.8-1.55),无统计学差异 (P = 0.22)。年龄对PFS没有任何影响。在两组中,尽管进行了131I治疗,疾病仍降低了OS。在 <65岁的患者中,初次诊断和诊断RAIR转移性疾病之间的间隔小于3年是预后差的预测。在> 65岁的患者中,纵隔转移的存在是死亡率的重要因素 (HR: 4.55,95% CI: 2.27-9.09)。 结论: 在RAIR-DTC患者中,65岁的截止年龄不是生存的重要预测因素。45岁和75岁的截止值预测OS,但不预测PFS。

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